Abstract
BackgroundRecent studies have implicated the differences in the ABO blood system as a potential risk for various diseases, including hemostatic disorders and hemorrhage. In this study, we evaluated the impact of the difference in the ABO blood type on mortality in patients with severe trauma.MethodsA retrospective observational study was conducted in two tertiary emergency critical care medical centers in Japan. Patients with trauma with an Injury Severity Score (ISS) > 15 were included. The association between the different blood types (type O versus other blood types) and the outcomes of all-cause mortality, cause-specific mortalities (exsanguination, traumatic brain injury, and others), ventilator-free days (VFD), and total transfusion volume were evaluated using univariate and multivariate competing-risk regression models. Moreover, the impact of blood type O on the outcomes was assessed using regression coefficients in the multivariate analysis adjusted for age, ISS, and the Revised Trauma Score (RTS).ResultsA total of 901 patients were included in this study. The study population was divided based on the ABO blood type: type O, 284 (32%); type A, 285 (32%); type B, 209 (23%); and type AB, 123 (13%). Blood type O was associated with high mortality (28% in patients with blood type O versus 11% in patients with other blood types; p < 0.001). Moreover, this association was observed in a multivariate model (adjusted odds ratio = 2.86, 95% confidence interval 1.84–4.46; p < 0.001). The impact of blood type O on all-cause in-hospital mortality was comparable to 12 increases in the ISS, 1.5 decreases in the RTS, and 26 increases in age. Furthermore, blood type O was significantly associated with higher cause-specific mortalities and shorter VFD compared with the other blood types; however, a significant difference was not observed in the transfusion volume between the two groups.ConclusionsBlood type O was significantly associated with high mortality in severe trauma patients and might have a great impact on outcomes. Further studies elucidating the mechanism underlying this association are warranted to develop the appropriate intervention.
Highlights
Recent studies have implicated the differences in the ABO blood system as a potential risk for various diseases, including hemostatic disorders and hemorrhage
There was a significant difference in all outcomes except for the number of units of Red blood cell (RBC) transfusions administered within 24 h
While there was no significant difference in Injury Severity Score (ISS) and Abbreviated Injury Scale (AIS) in all body regions, patients with blood type O had significantly lower Revised Trauma Score (RTS) than those with non-O blood type (mean 6.85 (standard deviation (SD) 1.43) in blood type O versus 7.13 (1.15) in other blood types; p = 0.003)
Summary
Recent studies have implicated the differences in the ABO blood system as a potential risk for various diseases, including hemostatic disorders and hemorrhage. The ABO blood system determines the carbohydrate moieties that are expressed on red blood cells (RBCs) and vascular endothelium. ABO antigens are highly expressed on the surface of a variety of human cells and tissues. At the beginning of the 20th century, from the time the system was discovered by Karl Landsteiner [1], the ABO blood type was studied widely in relation to diseases and blood transfusion complications. Recent studies have implicated that the ABO blood type is a potential risk for various diseases such as cancer, myocardial infarction, acute kidney injury, and venous thromboembolism [2–5]. The ABO blood type has a profound influence on hemostasis. The occurrence of venous thromboembolism is relatively rare in individuals with
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
